Pros And Cons Of Nitric Oxide

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Nitric Oxide (NO) is an inhaled gas that works via relaxation of the smooth muscles to dilate the blood vessels most commonly in the lungs (drugs.com, 2015). It is a blend of NO and Nitrogen and is used as a treatment for Acute Respiratory Distress Syndrome (ARDS) and Persistent Pulmonary Hypertension of the Newborn (PPHN) (Kumc.edu, 2015). This essays purpose is to inform about how it works, the uses for treatment, the type of patients most likely to benefit from NO, how it’s delivered, dosage, and also the hazards and complications that may come about when treating with NO.
NO is has a very similar name in regards to Nitrous Oxide, more commonly known as “laughing gas” but they should never be confused with each other because of the colossal …show more content…

Before NO is administered, the patient should be as stable as possible so sedation, blood pH, FiO2, and in rare cases muscle relaxers should be considered. For mechanically ventilated patients, when the patient is prepped, NO is administered with the use of delivery system that is able to put out a constant concentration throughout the patients breathing cycle (Eagans, 2013). Delivery systems, such as the INOmax DS can also be used with a facemask or nasal cannula (Eagan’s, 2013). When withdrawing NO therapy, the patient should be closely monitored because some patients that have not been weaned off correctly may develop worsening effects like hypoxemia. This is called the rebound effect and it happens because when a patient is given NO, it alters the body’s normal production of NO (Eagans, 2013). This is why the FiO2 needs to be increased frequently then reduced slowly to baseline over the course of 2 hours when the NO is no longer being used on the patient (Eagans, …show more content…

When high concentrations of NO is given to a patient, it can cause fatal acute pulmonary edema (Eagans, 2013) NO is also said to be linked with direct cellular damage even when given in low doses. Some side effects of NO include blurred vision, confusion, dizziness, sweating, chest discomfort, tightness in the chest, trouble breathing, methemoglobinemia, hypotension, atelectasis, stridor, and hyperglycemia (Drugs.com, 2015). NO can be used for a quick reduction in right ventricular afterload which may cause an increase left ventricular filling pressure in some cases (Eagans, 2013). A lot of the toxic effects of NO are caused by Nitrogen Dioxide (NO2), which is produced whenever NO comes in contact with Oxygen and is more toxic than NO where levels greater then 10 ppm can lead to problems with cell damage, pulmonary edema, hemorrhage, and death (Eagans, 2013). According to nih.gov, there are specific guidelines that should be followed in order to lessen the risk of toxicity when using NO, they are as follows: administer the lowest effective dose of NO with a maximum dose of 40-80 ppm, administer the lowest possible concentration of O2, monitor oxygen, nitric oxide, and nitrogen dioxide concentrations, and minimize exposure time of NO to oxygen as much as possible (nih.gov, 2002). Studies have shown that some patients, more than others, have proven difficult to wean off NO. This is

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